Paul M Petelin Jr., MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

29999 Issued in AZ

Practice address

14269 N 87TH St Ste 203
Scottsdale, AZ 85260-3695

Phone

(480) 483-8882

Fax

(480) 563-1413

NPI assigned

Oct 10, 2006

Last updated

Jul 29, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

University of Arizona College of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scottsdale Center for Sight, PLCGroup PAC ID 6305829789, 9 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1615/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Scottsdale Center for Sight, PLC

  • Ophthalmology Physician
  • Scottsdale, AZ
  • NPI 1265591374
  Medicare reassignment Care Compare group NPD
• Scottsdale Eye Surgery Center, P.C

  • Ambulatory Surgical Clinic/Center
  • Scottsdale, AZ
  • NPI 1295710002
  NPD
• Eye Physicians & Surgeons of Arizona, PC

  • Ophthalmology Physician
  • Glendale, AZ
  • NPI 1124140504
  NPD (past)
• Priority Hearing and Balance LLC

  dba Priority Hearing and Tinnitus

  • Audiologist
  • San Tan Valley, AZ
  • NPI 1962882746
  NPD (past)
• Tara Ransdell OD PLLC

  • Optometrist
  • Peoria, AZ
  • NPI 1104914316
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1245328871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14269 N 87TH ST STE 203",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603695",
            "telephone_number": "480-483-8882",
            "fax_number": "480-736-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14269 N 87TH ST STE 203",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603695",
            "telephone_number": "480-483-8882",
            "fax_number": "480-563-1413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 N Peart Rd",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851225344",
            "country_code": "US",
            "telephone_number": "480-895-9000",
            "fax_number": "480-563-1413",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10440 E Riggs Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Sun Lakes",
            "state": "AZ",
            "postal_code": "852487757",
            "country_code": "US",
            "telephone_number": "480-895-8900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10619 N Hayden Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852608510",
            "country_code": "US",
            "telephone_number": "480-948-0733",
            "fax_number": "480-443-5611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13613 W Camino Del Sol Ste 2",
            "address_purpose": "LOCATION",
            "city": "Sun City West",
            "state": "AZ",
            "postal_code": "853754480",
            "country_code": "US",
            "telephone_number": "623-584-2100",
            "fax_number": "623-584-0023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36889 N Tom Darligton Dr",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Carefree",
            "state": "AZ",
            "postal_code": "85377",
            "country_code": "US",
            "telephone_number": "480-488-8113",
            "fax_number": "480-488-0307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7727 W Deer Valley Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853822120",
            "country_code": "US",
            "telephone_number": "623-376-9070",
            "fax_number": "623-376-9079",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2490 W Ray Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852243559",
            "country_code": "US",
            "telephone_number": "480-857-3333",
            "fax_number": "480-857-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETELIN",
        "first_name": "PAUL",
        "middle_name": "M",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "29999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsey Pestello, CRNA
• Kristin E Petcher, PA
• Pete N Mellas DMD Ms PLLC
• Anthony John Petelin, M.D.
• Paul M Petelin Sr., MD
• Peter J. Ferrara M.D. P.C.
• Christine Peters
• Claudia M Peters, R.N.
• G Michael Peters, MD
• Jennifer Peters

• Ophthalmology Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Ophthalmology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.